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Pelvic Instability: What Pilates Instructors Need to Know, with Raphael Bender and Cloe Bunter

Episode 47:

Pelvic Instability: What Pilates Instructors Need to Know

On the show today, we’re talking about pelvic instability and why pelvic instability is simply not a thing. Learn why despite all the noise around the topic in the Pilates realm, you don’t have to worry about pelvic instability for yourself, and you don’t need to worry about it for your clients — including your prenatal clients. Encouraging cultural change in the fitness community is a passion of ours, and on the podcast this week, we’re spreading the truth and busting the myth of pelvic instability.

What You Will Learn:

  • Why the myth of pelvic instability is so hard to shake
  • Why pelvic pain is not correlated with the amount of movement at your pelvic joints
  • If you have pain in a specific movement, it doesn’t mean that there’s damage or physical danger
  • Why buying into the idea of pelvic instability, particularly in peri-natal clients, can be damaging
  • It’s ok to do splits, lunges, and stretches when pregnant

Evidence-Based Pilates Practice

Pilates consistently incorporates scientific evidence, but sometimes there is a lag in incorporating new evidence into practice, which kept Pilates instructors looking for pelvic instability treatments. We unpack the anatomy and the biomechanics of the concept of an unstable pelvis and explore the connotations of having someone believe they have an unstable pelvis.

Pregnant People and Pelvic Pain

The three joints of the pelvis, the left and right sacroiliac joints and the symphysis pubis, are affected by additional relaxin in pregnancy. It binds to receptors on ligaments throughout the body and triggers chemical changes that result in the ligaments temporarily becoming more flexible. As a result, pregnant people do have more flexible joints, and it is more common for people to have pain during pregnancy than when they’re not pregnant, but the relaxing of the ligaments is not the cause of pelvic pain.

Movement Misconceptions

We want to inspire, empower and shine a light on the truth behind movement misconceptions. For example, if you have pain in a specific movement, it doesn’t mean that there’s damage or physical danger; it just means the nervous system correctly or incorrectly perceives a threat. Likewise, if your client is feeling slight pain, it doesn’t necessarily mean they need to stop the movement — consider your clients’ tolerance of the symptom instead and adapt the move as necessary.

Pelvic instability

Research & Resources mentioned in this episode:

  • No evidence that relaxin is related to pelvic girdle pain during pregnancy here and here
  • The biggest risk factors for pelvic pain postpartum are a history of low back pain, being overweight, pelvic pain during pregnancy, depression & heavy workload in pregnancy here
  • The sacroiliac joint basically doesn’t move here and here and here
  • Including in women diagnosed with “sacroiliac dysfunction” here
  • Clinical tests (e.g. palpation) of SIJ mobility are highly unreliable and inaccurate here and here
  • In fact palpation of all lumbopelvic landmarks is highly inaccurate and not considered valid for clinical practice here
  • Manipulation doesn’t change the position of the sacroiliac joint here
  • Pretty much any form of physical activity during & after pregnancy reduces the severity of pelvic girdle pain here and here
  • Including general aerobic and strengthening exercises taught in a group setting here
  • Pelvic floor training is not superior to general exercise for pelvic pain here
  • There is no solid evidence for the effectiveness of stabilising exercises for pregnancy-related pelvic girdle pain here
  • There is no current evidence to support the validity of pregnancy related pelvic girdle pain classification systems here
  • There is currently a lack of well-designed studies to demonstrate related to physical therapy interventions for pregnancy-related pelvic girdle pain here
  • Factors that predict poor outcomes in pregnancy-related pelvic girdle pain are obesity, severe symptoms, history of low back pain, and emotional distress here
  • No difference in mobility between painful and non-painful sacroiliac joints in women with pelvic pain here
  • It’s not research, but it’s awesome – listen to Adam Meakins and Amy Busch-Eicher on the NAF Physio podcast here

About Raphael and Cloe:

Raphael Bender, CEO, Breathe Education

Raph believes everyone deserves the opportunity to transform into a better version of themselves. His main strength as a teacher and movement professional is the ability to distill complex research findings into a simple, science-based approach to help people move fearlessly, thoughtlessly, and painlessly. He LOVES running, weights, cycling, and Contrology.

Raph holds a Master’s degree in Clinical Exercise Physiology (Rehabilitation), a Bachelor’s degree in Exercise and Sports Science, Diploma of Pilates Movement Therapy, and STOTT PILATES full certification.

Cloe Bunter, Trainer, Breathe Education

With 8+ years in the industry, both teaching Pilates and nurturing new instructors, Cloe is passionate about empowering new and seasoned instructors to think critically and move fearlessly. Empowered instructors empower their clients, and in turn, change lives.

She finds great joy in building connections with clients, students, colleagues, and the broader movement and rehab community. Co-hosting the Pilates Elephants Podcast, with Raphael Bender, has provided an incredible platform to bust common Pilates, movement, and rehab myths whilst creating a worldwide community of critical thinkers who are elevating health literacy.

Cloe is fascinated by movement in general, and its ability to enhance our lives, at any age. Her own movement practice includes Contrology/Pilates, running, weights, and kettlebells. She has a Diploma of Clinical Pilates, Cert IV in Pilates, and Cert IV in Training and Assessing.

How to Connect with Raphael and Cloe:

3 Myths About Posture in Pilates eBook:

  • You can find the eBook here

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